Emergencies

Most emergencies are seen the same day. Emergencies can fall in to 4 main categories

• trauma
• discomfort after a dental appointment
• toothache
• tooth or appliance broken

Dental injuries require immediate attention and appropriate response. One of every four people in Canada suffers an oral injury during their lifetime. Knowing how to handle these emergencies can mean the difference between saving or losing a tooth.

Many dental emergencies can be handled with a phone call, as they only require a prescription which can be done over the phone. Other emergencies need a dentist to physically help you. Let Dr. Campbell be the judge of which route fits your emergency

When in doubt please phone Dr. Campbell 604 872 2941 the answering service will always direct you to a number where she can be reached or you can reach someone she has chosen in the event that she is unavailable.

Some common problems and things you can do

TOOTH KNOCKED OUT

• If you were unconscious at any stage, go to the Dr./hospital for a full assessment
• If there are cuts to the face that need stitching, go to the Dr./hospital
• If the tooth is knocked out and you can not find the missing tooth/pieces it may have been inhaled so go to the Dr./hospital
• If the tooth is knocked out, find the tooth and pick the tooth up by the crown (chewing surface) NEVER the root as this may damage the chances of it reattaching itself to the bone
• GENTLY rinse the tooth off in body temperature water to remove dirt, being careful not to touch the root. DO NOT: scrub the tooth, dry the tooth off or wrap in a tissue or cloth!
• Try to place the tooth back in the socket by carefully and firmly pushing the tooth into the socket with your fingers. Bite down and hold it there with a clean wash cloth. If the tooth can be reimplanted within 30 minutes the chance of retaining the tooth is high.
• The tooth can be stored in: water for up to 15 minutes, saliva for 30 minutes, milk for 1 hour
• Keep the tooth moist at ALL times. If you can not get the tooth back in the socket place it in clean milk, sterile contact lens saline, or saliva. If you don’t have milk put the tooth: next to the cheek or under your lip (be careful not to swallow it); emergency tooth preservation kit or if nothing else is available, water with a pinch of salt.
• Try to get to the dentist within one hour and bring the tooth with you so it can be splinted in place
• Liquid diet

TOOTH PUSHED OUT OF PLACE (INWARD/OUTWARD)

• It can be repositioned to its normal alignment with very light finger pressure
• Do not force the tooth into the socket
• Hold the tooth in place with a moist tissue/gauze
• It is vital to see the dentist as soon as possible

CROWN COMES OFF

• Try to snap it back in
• Purchase a small tube of denture adhesive paste put a small amount in the crown and place it back on your tooth
• Do NOT use ordinary household glue
• Call the dentist as soon as possible to re-cement it properly

BROKEN/ FRACTURED /CHIPPED TOOTH OR FILLING

• If the tooth is broken/chipped/fractured and there is no other damage requiring hospital care go to the dentist within 2-3 hours. Quick action can save the tooth, prevent infection and reduce the need for extensive dental treatment. The dentist can smooth minor chips. The tooth may also need to be restored with a composite filling.
• Stop any bleeding by applying direct gentle pressure to the gums.
• If an upper tooth, apply pressure to the gums above the tooth.
• If a lower tooth, apply pressure to the gums below the tooth. Do NOT press directly on the broken tooth.
• Rinse the mouth with warm water and apply cold compresses to reduce swelling.
• Find the broken tooth fragments and bring the pieces with you, they may be able to be "cemented" back together
• To avoid further aggravation from the damaged tooth, place a piece of soft wax into the area that was chipped. You can also try Dentemp or Tempanol for temporary filling material.
• Eat only soft foods.
• Avoid this side of your mouth when eating.
• Avoid food and drink that are hot or cold, eat only lukewarm.
• Do not take aspirin or aspirin-substitutes that can slow clotting. Try 400-800 mg of ibuprofen (Advil or Motrin) or 200-400 mg of naproxen sodium (Aleve)...if you are not allergic or have any medications that could interact with these medications. Follow instructions on the bottle and your doctor’s instructions.
• The more the tooth is bothering you before you go to the dentist the more difficult it is for the dentist to treat you comfortably.
• If the pulp is damaged it can mean a root canal.
• This tooth may need a full permanent crown to protect if from further breakage and tooth loss.

BROKEN DENTURE, BRIDGE, OR PLATE

• Save all the parts of your broken denture, bridge or partial
• Call your dentist
• If it is possible it may be repaired or it may need to be replaced as soon as possible
• Temporary bridges, plates and dentures can keep you comfortable until the permanent one is repaired or replaced

BLEEDING AFTER AN EXTRACTION

• Slight bleeding after an extraction is normal. Clots usually form
• Within one hour if you follow doctor’s post-op instructions.
• Place a thick gauze pad over the extraction site and apply pressure by biting on the gauze
• Avoid rinsing, drinking or eating for at least one hour following the extraction
• After 24 hours rinse the area with warm salt water(1/2 tsp. salt in 8 oz of water) after eating to keep the site clean
• Avoid sucking, spitting, and smoking

PAIN AFTER 36 HOURS AFTER AN EXTRACTION Dry Socket

Contact your dentist you could have a “dry socket” or infection which will need specific attention.

NUMBNESS CONTINUES AFTER EXTRACTION

If a tooth has been extracted on the lower back area, it is possible that you may not regain full sensory feelings immediately After 24 hour contact your dentist to advise on symptoms

STILL UNHEALED EXTRACTION SITE

If you are still unhealed one week after an extraction you need to go to the dentist for an X-ray to see if a root tip or fragment is still embedded. Do NOT wait to see your dentist